General Principals of CPTP - 60 questions

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In preclinical development of drugs, which statement is the most correct?
Important to test for species variation in 2 animal species, including 1 non-rodent, via 2 routes of administration
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Phase 1 clinical trials are used to
Confirm pharmacology established in preclinical development
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Phase 2 clinical trials are used to
Establish the therapeutic value, determine the effective dose range and explore common adverse effects of a drug
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Assuming equal efficacy between drugs and choosing the cheapest one is an example of what?
Cost minimisation
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Choosing a drug based on efficacy and cost is an example of what?
Cost effectiveness
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Cost effectiveness is measured by what?
ICER
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Choosing a drug based on cost, efficacy and utility (benefit, happiness, comfort, ability etc.)
Cost utility
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Which is incorrect about QALY
It is used to measure cost benefit
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Choosing a drug based on net monetary gain, after valuing all outputs and inputs in monetary terms, is an example of what?
Cost benefit
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A medication error is...
Any preventable event which may cause or lead to inappropriate medication use or patient harm, while the medication is in the control of the healthcare professional
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What is an adverse drug reaction?
Any response to a drug which is noxious, unintended and occurs at doses used for prophylaxis, diagnosis or therapy
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The development of osteoporosis with the use of steroids, is an example of what type of adverse drug reaction?
C = chronic treatment effects
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Bleeding whilst on warfarin is an example of what type of adverse drug reaction?
A = augmented/avoidable (dose-related and predictable)
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Anaphylaxis after taking penicillin is an example of what type of adverse drug reaction?
B = bizarre (non-dose related and not predictable)
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The development of breast cancer after prolonged HRT use is an example of what type of adverse drug reaction?
D
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The development of adrenocortical insufficiency after steroid treatment is an example of what type of adverse drug reaction?
E
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A relationship between the doctor and the patient, in which they make an agreement about treatment, demonstrates what?
Concordance
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Compliance is...
The extent to which the patient's behaviour matches the prescriber's recommendations
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The extent to which the patient's actions or behaviour matches the agreed recommendation from the prescriber
Adherence
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What is therapeutic drug monitoring?
The individualisation of dosage by maintaining plasma drug concentrations within a target range (can also be measured by clinical response or pharmacodynamic effects)
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The clinically meaningful alteration in the effect of one drug (object) as a result of co-administration of another drug/food/chemical (precipitant), is an example of what?
Drug interaction
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If drugs act on the same target sites of clinical effect, this is an example of what type of drug interaction?
Pharmacodynamic
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If drug concentration is altered a target site of clinical effect, this is an example of what type of drug interaction?
Pharmacokinetic
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Which medication should you not prescribe when taking salutamol inhaler, and why?
B-blockers e.g. atenolol - antagonistic effects of bronchodilation and bronchoconstriction
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The effects of taking quinidine whilst taking digoxin include...
Displacement of digoxin from cardiac receptors (so more free digoxin and risk of toxicity), and reduced excretion (increased steady state concentrations)
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When CYP450 enzymes are induced, what happens?
Increased number, thus accelerating metabolism of drug
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Which CYP450 enzyme does grapefruit and cranberry juice inhibit?
CYP3A4
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A patient who has a long history of RA is diagnosed with a UTI and is treated with trimethoprim. After the first few doses, they become very unwell with a pancytopenia. Why?
Methotrexate and trimethoprim are both dihydrofolate reductase inhibitors, resulting in folate deficiency and bone marrow suppression
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What happens if you take theophylline (asthma and COPD medication) and ciprofloxacin together?
Increase in theophylline to toxic doses = headaches, dizziness, hypotension, tachycardia, hallucinations and seizures
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A man who has been on warfarin for many years, is treated for an infection with erythromycin. He dies 2 days later of internal bleeding. Why?
Erythromycin is a CYP450 enzyme inhibitor
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You want to start a 70yr old lady on warfarin as she has AF, but she currently takes paracetamol, ibuprofen and codeine for her joint pain - what changes should you make?
Take her off NSAIDs before starting warfarin - enzyme inhibitor = increased effects of warfarin and risk of bleeding
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What is the yellow card system used for?
To flag up possible ADRs that have occurred, in order to identify them early
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When a higher dose of a drug is needed to achieve the same level of response achieved initially, this is known as
Tolerance
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When neurones adapt to repeated drug exposure and only function normally in the presence of the drug (withdrawal precipitates unwanted effects)
Physical dependence
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Emotional need for a drug which has no underlying physical need
Psychological dependence
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A patient arrives at A&E and you suspect they have taken an illicit substance - which? They are confused and bradycardic, with hypotension, and have miosis
Depressant e.g. opoiod
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A patient arrives at A&E and you suspect they have taken an illicit substance - which? They are euphoric, sweaty, hypertensive, tachycardic and have a metabolic acidosis
Stimulant e.g. cocaine
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A patient arrives at A&E and you suspect they have taken an illicit substance - which? They are mildly confused/agitated and have had some hallucinations. They have a dry mouth.
Hallucinogen e.g. cannabinoid
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The Psychoactive Substances Act of 2016 states that it is an offence to...
Import or supply any psychoactive substance, if the substance is likely to be used for its psychoactive effects
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What is the role of the Human Medicines Regulation (2012)?
Categorises medicinal substances into prescription only, pharmacy and general sales lists
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Which is not legally required on a prescription?
Time of prescription
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Which is not legally required when prescribing controlled drugs?
Second signature
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Other cards in this set

Card 2

Front

Phase 1 clinical trials are used to

Back

Confirm pharmacology established in preclinical development

Card 3

Front

Phase 2 clinical trials are used to

Back

Preview of the front of card 3

Card 4

Front

Assuming equal efficacy between drugs and choosing the cheapest one is an example of what?

Back

Preview of the front of card 4

Card 5

Front

Choosing a drug based on efficacy and cost is an example of what?

Back

Preview of the front of card 5
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